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Open Access Highly Accessed Research article

Motives for khat use and abstinence in Yemen - a gender perspective

Felix Wedegaertner1*, Hussein al-Warith2, Thomas Hillemacher1, Bert te Wildt1, Udo Schneider2, Stefan Bleich1 and Dirk Breitmeier3

Author Affiliations

1 Center for Addiction Research, Department of Psychiatry, Social Psychiatry and Psychotherapy, OE 7110, Hannover Medical School, 30623 Germany

2 Department of Psychiatry, Psychotherapy and Psychosomatics, Luebbecke Hospital, Germany

3 Department of Forensic Medicine, Medical Faculty, University of Mainz, Germany

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BMC Public Health 2010, 10:735  doi:10.1186/1471-2458-10-735

Published: 27 November 2010

Abstract

Background

Khat consumption is widespread in Yemeni society and causes problems both in economic development and public health. Preventive measures have been largely unsuccessful and the cultivation continues to proliferate. The gender-specific motives for khat use and abstinence were studied to create a toe-hold for more specific interventions.

Methods

In a quota sample with equal numbers of males, females, abstainers and consumers, 320 subjects were interviewed on their specific opinions about khat and its impact on subjective and public health, and on social and community functioning. Strata were compared in their acceptance and denial of opinions. Notions that could predict abstinence status or gender were identified with multivariate logistic regression analysis.

Results

Male khat users had a strong identification with khat use, while females were more ambivalent. The notion that khat consumption is a bad habit (odds ratio (OR) 3.4; p < 0.001) and consumers are malnuorished (OR 2.2; p = 0.046) were associated with female gender among khat users. Among the females worries about health impact (OR 3.2; p = 0.040) and loss of esteem in the family (OR 3.1; p = 0.048) when using khat predicted abstinence. Male abstainers opposed khat users in the belief that khat is the cause of social problems (OR 5.1, p < 0.001). Logistic regression reached an accuracy of 75 and 73% for the prediction of abstinence and 71% for gender among consumers. (All models p < 0.001.)

Conclusions

Distinct beliefs allow a differentiation between males, females, khat users and abstainers when targeting preventive measures. In accordance to their specific values female khat users are most ambivalent towards their habit. Positive opinions scored lower than expected in the consumers. This finding creates a strong toe-hold for gender-specific public health interventions.